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Clinical prognostic factors for disabling Crohn's disease: A systematic review and meta-analysis

World Journal of Gastroenterology 2013年第24期19卷 3866-3871页

作者： Cláudia Camila Dias Pedro Pereira Rodrigues Altamiro da Costa Pereira Fernando Magro Health Information and Decision Sciences Department Faculty of Medicine University of Porto4200-319 Porto Portugal Centre for Research in Health Informatics Systems and Technologies (CINTESIS) 4200-319 Porto Portugal Laboratory of Artificial Intelligence and Decision Support INESC TEC Artificial Intelligence and Decision Support Laboratory4200-465 Porto Portugal Centro Hospital de So Joo Institute of Pharmacology and Therapeutics Faculty of Medicine Univer-sity of Porto4200-319 Porto Portugal Institute for Molecular and Cell Biology (IBMC) 4150-180 Porto Portugal

AIM: To identify demographic and clinical factors asso-ciated with disabling Crohn's disease (CD). METHODS: A systematic review and meta-analysisof observational studies, focusing on the factors that can predict the prognosis of different outcomes of CD was undertaken. PubMed, ISI Web of Knowledge and Scopus were searched to identify studies investigat-ing the above mentioned factors in adult patients with CD. Studies were eligible for inclusion if they describe prognostic factors in CD, with inclusion and exclusion criteria defined as follows. Studies with adult patients and CD, written in English and studying association between clinical factors and at least one prognosis out-come were included. Meta-analysis of effects was un-dertaken for the disabling disease outcome, using odds ratio (OR) to assess the effect of the different factors in the outcome. The statistical method used was Mantel-Haenszel for fixed effects. The 16-item quality assess-ment tool (QATSDD) was used to assess the quality of the studies (range: 0-42). RESULTS: Of the 913 papers initially selected, sixty studies were reviewed and three were included in the systematic review and meta-analysis. The global QA-TSDD scores of papers were 18, 21 and 22. Of a total of 1961 patients enrolled, 1332 (78%) were classified with disabling disease five years after diagnosis. In two studies, age at diagnosis was a factor associated with disabling disease five years after diagnosis. Individu-als under 40 years old had a higher risk of developing disabling disease. In two studies, patients who were treated with corticosteroids on the first flare developed disabling disease five years after diagnosis. Further, perianal disease was found to be relevant in all of the studies at two and five years after diagnosis. Finally, one study showed localization as a factor associated with disabling disease five years after diagnosis, with L3 being a higher risk factor. This meta-analysis showed a significantly higher risk

关键词： Crohn’s disease disabling disease Prognos-tic factors Outcome Systematic review Meta-analysis

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